Background: Applying pressure to key points proximal to craniofacial arteries can arrest bleeding in first aid, but precise locations are poorly defined. This study investigates the precise pressure points within the craniofacial region.
Methods: The authors retrospectively reviewed CTA scans from 201 adults, 3D postprocessed in HOROS. The facial, superficial temporal, occipital, transverse facial, and posterior auricular arteries were analyzed. Three coordinate systems-anchored at the angulus oris, the porus acusticus externus, and the external occipital protuberance-were used to map the optimal compression site. The authors measured the linear distance from each landmark to its pressure point and recorded vessel diameters. All measurements were bilateral and averaged across the cohort; interindividual variability was also analyzed.
Results: Ten bilateral pressure points were identified and found to lie consistently within reach of thumb or 2-finger compression. Points for the facial and occipital arteries sit farther from their landmarks-along the mandible and posterior scalp-than those for the superficial temporal, transverse facial, and posterior auricular arteries. The latter 3 cluster along the auricular contour, such that a single compressive gesture can address over 95% of these points. Although most subjects exhibited consistent arterial courses, anatomic variations in branching patterns of the facial, transverse facial, and occipital arteries may necessitate palpation for pulsation before applying pressure.
Conclusions: This atlas of craniofacial pressure points offers practical, anatomically precise guidance for first-aid responders and can enrich hemorrhage-control training programs, with potential for incorporation into simulation and augmented-reality tools.
Keywords: Craniofacial bleeding; emergency management; first aid training; proximal pressure.
Copyright © 2025 by Mutaz B. Habal, MD.